Abstract

Background

Aboriginal and Torres Strait Islander people with chronic illness confront multiple
challenges that contribute to their poor health outcomes, and to the health disparities
that exist in Australian society. This study aimed to identify barriers and facilitators
to care and support for Aboriginal and Torres Strait Islander people with chronic
illness.

Methods

Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait
Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary
disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and
the transcripts were analysed using content analysis. Recurrent themes were identified
and these were used to inform the key findings of the study.

Results

Participants reported both negative and positive influences that affected their health
and well-being. Among the negative influences, they identified poor access to culturally
appropriate health services, dislocation from cultural support systems, exposure to
racism, poor communication with health care professionals and economic hardship. As
a counter to these, participants pointed to cultural and traditional knowledge as
well as insights from their own experiences. Participants said that while they often
felt overwhelmed and confused by the burden of chronic illness, they drew strength
from being part of an Aboriginal community, having regular and ongoing access to primary
health care, and being well-connected to a supportive family network. Within this
context, elders played an important role in increasing people’s awareness of the impact
of chronic illness on people and communities.

Conclusions

Our study indicated that non-Indigenous health services struggled to meet the needs
of Aboriginal and Torres Strait Islander people with chronic illness. To address their
complex needs, health services could gain considerably by recognising that Aboriginal
and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal.
Strategies to ensure that this knowledge is integrated into care and support programs
for Aboriginal and Torres Strait Islander people with chronic illness should achieve
major improvements.